Analyse d’une série de 44 cas de tuberculose péritonéale diagnostiqués au laboratoire d’anatomie pathologique du CHU Tokoin de Lomé (1993-2014)

Abstract

It is a descriptive and cross-sectional study on all issues relating to peritoneal tuberculosis histological diagnosed in the pathology department (LAP) of the Lomé Tokoin CHU from January 1993 to December 2014 (20 years). A total of 44 cases of peritoneal tuberculosis were included. They were 18 women and 26 men, with a mean age of 37.6±0.2 years. The circumstances of discovery were dominated by ascites (84.1%), fever (75%), weight loss (63.6%) and abdominal pain (59.1%). The peritoneal involvement was isolated in 31.8% of cases, and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was present in 63.9% of cases. Twenty-five patients (69.4%) with information about their social conditions had low socioeconomic level: unemployed (10 cases; 40%), workers (10 cases; 40%) and retired (5 cases; 20%). An increase in cell count was observed in 94.6% of cases. Histology revealed the epithelial giant cell granuloma associated with caseous necrosis in 38 cases (86.4%) and cheesy isolated in 6 patients. Peritoneal tuberculosis is not exceptional in our country. The diagnosis should be considered in febrile ascites, and will be confirmed by laparoscopy with histological samples for a histological diagnosis.

Extra-Pulmonary Tuberculosis: Retrospective Review of 83 Confirmed Cases, Observed in Radiology in Lomé (TOGO)

“…Co-infection with HIV was high, up to 61.1% of cases. This rate is close to that of Darré et al [4] who considers that HIV is changing the face of tuberculosis. Actually according to the World Health Organization (WHO), in Africa, HIV is the main cause of the increase of TB impact during the past decade [5].…”

“…This position is related to the large number of peritoneal tuberculosis cases in our series which accounted for 11.2% of all locations. Peritoneal tuberculosis is the most common form of abdominal tuberculosis [16]; it represented 7.2% of extra-pulmonary TB in a study in one of pathological rooms at the Teaching Hospital of Lomé [4]. This difference between our study and that of Darré et al [4] could be explained by the low proportions of other locations including ganglionic, genitor-urinary and gastrointestinal diseases that were not often explored by imaging or when the radiological exploration is made, the levy for bacteriological or histological confirmation is not easy.…”

Ultrasonography of peritoneal tuberculosis

“…All peritoneal structures may be involved: parietal peritoneum, mesentery of small bowels and large omentum (22–24) . Ascites is the most commonly found; 84.2% in our series, as reported by many African authors (16,23) . It is often divided by septas (24) .…”

“…The main clinical symptoms include ascites, alteration of the general condition and fever (76%, 68% and 63% respectively in our patients). This predominance is reported almost in all series of the literature (15,16) . Abdominal pain reported in 36%–73.8% of patients is most often moderate (5,8,17) ; much more rarely these pains are in the foreground mimicking acute peritonitis (17) .…”

“…Adenomegaly is found in 34.3% of patients, most often with necrotic appearance; frequency comparable to some African studies (23,33) . Other African authors report a much lower frequency, less than 10% (5,16) . The association with progressive pulmonary tuberculosis is possible (5) .…”